ATI RN
ATI Capstone Comprehensive Assessment B
1. The nurse is providing information regarding safety and accidental poisoning to a grandparent who will be taking custody of a 1-year-old grandchild. Which comment by the grandparent will cause the nurse to intervene?
- A. I should call 911 if my grandchild loses consciousness.
- B. Never induce vomiting if my grandchild drinks bleach.
- C. If my grandchild eats a plant, I should provide syrup of ipecac.
- D. The number for poison control is 800-222-1222.
Correct answer: C
Rationale: The correct answer is C. Administering syrup of ipecac is no longer recommended in cases of poisoning. This is because it can lead to complications and is not considered safe. The grandparent should be informed that syrup of ipecac should not be given to a child who has ingested a toxic substance. Choices A, B, and D provide accurate information regarding actions to take in case of poisoning, such as calling 911 if the child loses consciousness, not inducing vomiting if the child drinks bleach, and having the poison control number readily available.
2. What is the most appropriate action for a healthcare provider to take when a patient refuses a prescribed medication?
- A. Document the refusal and notify the healthcare provider.
- B. Administer the medication at a later time.
- C. Explain the importance of the medication and its effects.
- D. Respect the patient's right to refuse the medication.
Correct answer: D
Rationale: The correct answer is to respect the patient's right to refuse the medication. It is crucial to uphold the patient's autonomy and decision-making capacity when it comes to their treatment. Administering the medication later without the patient's consent (Choice B) disregards their autonomy and can lead to ethical issues. Documenting the refusal and notifying the healthcare provider (Choice A) is important for legal and continuity of care purposes but should come after respecting the patient's decision. While explaining the importance of the medication (Choice C) is valuable for promoting understanding and compliance, the immediate concern should be respecting the patient's refusal.
3. A client is about to undergo surgery and is unsure about the procedure despite signing the consent. What should the nurse do?
- A. Reassure the client and proceed with the surgery.
- B. Stop the surgery and consult with the surgeon.
- C. Proceed with the surgery but document the client's concerns.
- D. Postpone the surgery until further clarification is provided.
Correct answer: B
Rationale: When a client expresses doubts about a procedure after signing the consent form, it is crucial to stop the surgery and consult with the surgeon. This is important to ensure that the client's concerns are addressed, and there is a clear understanding of the procedure. Reassuring the client and proceeding with the surgery (choice A) may violate the client's autonomy and right to informed consent. Proceeding with the surgery but documenting the concerns (choice C) is not sufficient as the client's doubts should be resolved before proceeding. Postponing the surgery until further clarification is provided (choice D) may be necessary, but the immediate step should be to consult with the surgeon to address the client's concerns.
4. A healthcare provider is caring for a client who has an indwelling urinary catheter. Which of the following assessment findings indicates that the catheter requires irrigation?
- A. Bladder scan shows 525 mL
- B. Absent urinary output for 1 hour
- C. Cloudy urine
- D. Bloody urine
Correct answer: A
Rationale: The correct answer is A. A large bladder scan result (525 mL) suggests catheter blockage and may require irrigation to resolve. Choice B (absent urinary output for 1 hour) could indicate a different issue such as urinary retention but does not specifically indicate the need for catheter irrigation. Choices C (cloudy urine) and D (bloody urine) may suggest infection or other urinary issues, but they do not directly indicate the need for catheter irrigation.
5. A client is administering insulin. Which statement by the client shows proper understanding of insulin administration?
- A. I will inject insulin into my thigh before exercise
- B. I will skip meals to lower blood sugar
- C. I will store my insulin in the freezer
- D. I will rotate injection sites for insulin administration
Correct answer: D
Rationale: The correct answer is D because rotating injection sites prevents tissue damage and ensures better absorption of insulin. Option A is incorrect as injecting insulin into the thigh before exercise can lead to hypoglycemia. Option B is incorrect as skipping meals can cause blood sugar levels to drop dangerously low. Option C is incorrect as insulin should not be stored in the freezer as it can alter its effectiveness.
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